PROGESS REPORT:

The National LF Programme

In Indonesia
Ministry of Health of Indonesia
Malaka, October 5th, 2019
 Background Information
 Geography and Population
 The Large is 1,905,000 km2
 Ecological zones: tropical climate, and archipelagic
geography
 Consist of 17,508 islands, extending 5,120 km from
east to west and 1,760 km from north to south.
Only 6,000 are inhabited
 Four of the islands are shared with other nations:
Borneo is shared with Malaysia and Brunei; Sebatik
shared with Malaysia; Timor is shared with East
Timor, and Papua shared with Papua New Guinea.
 34 Provinces, 514 Districts, 7,271 Subdistricts
 Total population : 260 million

 Political & Health Administrative Divisions

 First level : Province
 Second level : District/City
 Third level : Sub-district
 LF and STH Burden in Indonesia
LF ENDEMIC AREA BY PARACITE AND DISTRICT
 LF endemic district : 236/514
 Total pop. At risk : 102
million
 Causative agent :
Brugia malayi, Wuchereria
bancrofti, & Brugia timori

 STH endemic district : 514/514

 Inadequate access of WASH
in some areas increased STH
infection
LF ELIMINATION PROGRESS IN INDONESIA 2018

16.1 million people from 102 million population at risk

have been protected from LF transmission
LF ELIMINATION PROGRESS IN INDONESIA 2019
514
Districts/Cities

278 236
Non Endemic Endemic
Districts/Cities Districts/Cities

118 118
Districts/Cities Districts/Cities
Stop LF MDA remain LF MDA

27 96
Districts/Cities Districts/Cities
TAS 3 Passed Post Surveillance MDA

21.7 million people from 102 million population at risk have been protected from LF transmission
 Progress Towards LF Elimination in Indonesia
2018 2019

Started MDA STARTED MDA 100%

100%
≥5 MDA rounds 45% ≥5 MDA ROUNDS 50%

Surveillance Post MDA 42% SURVEILLANCE POST MDA 44%

MMDP access 56% MMDP ACCESS 50%

0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% 120%

Definitions Definitions

Started MDA ≥5 MDA rounds Surveillance MMDP access Started MDA ≥5 MDA rounds Surveillance MMDP access
236 105 98 131 236 118 103 118
236 236 236 236 236 236 236 236
 PC Monitoring and Evaluation

Describe how coverage is monitored

• Implement MDA Supervision trip by national/province
• Conduct coverage survey in some areas
• Encourage the health workers to ensure the community taking medicine in front of them
• sweeping of MDA eligible targeted if the coverage still low.
• cross-checked for the completeness and calculation errors at the national level

SAE protocol
 Health center as front line to detect any SAE (24 hours standby) during 5 days MDA
implementation
 Community Cadres  midwives  health center  hospital
 National level ( Task Force for Medical Experts)
LF Transmission Assessment

Number of IUs to be covered Total number of

Year TAS1 TAS2 TAS3 EUs

2018 36 11 5 57

2019 5 23 6 34

2020 15 38 9 66
 LF MMDP – Monitoring and Evaluation
LF
Describe how MMDP services are currently Patient form record and follow up
monitored and reported to the national form
programme
How is “access” determined? Follow up through 7 times visiting
patien

Is there any quality assessment of provided NA

services?
 Best Practices

• Improving social awareness by provide IECs e.g Advertising through

Mass media, jingle, advertising on radio with local language.
• Well-trained TAS Supervisors
• Well-trained STH Surveyors
• Deworming is integrated with Vitamin A Supplementation programme for
Pre-SAC targeted and for SAC with school health ( SAC)
• STH MDA become one of specific intervention to reduce stunting
• Community empowerment and awareness activities in controlling snail foci
e.g. spraying foci area with molucide, cleaning the foci areas every once in
two weeks.
 Challenges of the Elimination Program
LF and STH Programme:
• More support is needed to scale up MDA in remaining endemic areas
especially in difficult Geographical areas to improve epidemiological
coverage
• Pre TAS un-success (2 districts) need extra effort to monitoring
people swallow the drugs
• Difficult access to conduct evaluation surveys in remote area
• Inadequate access of water sanitation and hygine
 TERIMA KASIH

Directorate General Diseases Prevention and Control

Detect l Prevent l Respond Pantai Motadikin, Malaka Tengah